| NPI | 1639391931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NC 2008-00054) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MT183990) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2010-12-13 |